Journal article
Surgical management of gastroesophageal reflux disease (GERD) in children: A systematic review
Journal of pediatric surgery, Vol.52(8), pp.1228-1238
08/2017
DOI: 10.1016/j.jpedsurg.2016.09.072
PMID: 27823773
Abstract
The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to derive recommendations from the medical literature regarding the surgical treatment of pediatric gastroesophageal reflux disease (GERD).
Five questions were addressed by searching the MEDLINE, Cochrane, Embase, Central, and National Guideline Clearinghouse databases using relevant search terms. Consensus recommendations were derived for each question based on the best available evidence.
There was insufficient evidence to formulate recommendations for all questions. Fundoplication does not affect the rate of hospitalization for aspiration pneumonia, apnea, or reflux-related symptoms. Fundoplication is effective in reducing all parameters of esophageal acid exposure without altering esophageal motility. Laparoscopic fundoplication may be comparable to open fundoplication with regard to short-term clinical outcomes. Partial fundoplication and complete fundoplication are comparable in effectiveness for subjective control of GERD. Fundoplication may benefit GERD patients with asthma, but may not improve outcomes in patients with neurologic impairment or esophageal atresia. Overall GERD recurrence rates are likely below 20%.
High-quality evidence is lacking regarding the surgical management of GERD in the pediatric population. Definitive conclusions regarding the effectiveness of fundoplication are limited by patient heterogeneity and lack of a standardized outcomes reporting framework.
Systematic review of level 1–4 studies.
Level 1–4 (mainly level 3–4)
Details
- Title: Subtitle
- Surgical management of gastroesophageal reflux disease (GERD) in children: A systematic review
- Creators
- Tim Jancelewicz - Division of Pediatric Surgery, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, 49 North Dunlap, Second Floor, Memphis, TN, 38105Monica E Lopez - Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TXCynthia D Downard - Division of Pediatric Surgery, Hiram C. Polk, Jr., M.D. Department of Surgery, Program Director, Pediatric Surgery Fellowship, University of Louisville, Louisville, KYSaleem Islam - University of Florida, Gainesville, FLRobert Baird - Department of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, QCShawn J Rangel - Department of Pediatric Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MARegan F Williams - Division of Pediatric Surgery, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, 49 North Dunlap, Second Floor, Memphis, TN, 38105Meghan A Arnold - CS Mott Children's Hospital, University of Michigan, Ann Arbor, MIDave Lal - Division of Pediatric Surgery, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WIElizabeth Renaud - Department of Surgery, Division of Pediatric Surgery, Albany Medical Center, Albany, NYJulia Grabowski - Ann and Robert H. Lurie Children's Hospital, Northwestern University, Chicago, ILRoshni Dasgupta - Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Medical Center, Cincinnati, OHMary Austin - Department of Pediatric Surgery, The University of Texas Medical School at Houston and in Surgical Oncology and Pediatrics at the UT M.D., Anderson Cancer Center, Houston, TXJulia Shelton - Division of Pediatric Surgery, University of Iowa Children's Hospital, Iowa City, IADanielle Cameron - Department of Pediatric Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MAAdam B Goldin - Division of Pediatric General and Thoracic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric surgery, Vol.52(8), pp.1228-1238
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jpedsurg.2016.09.072
- PMID
- 27823773
- ISSN
- 0022-3468
- eISSN
- 1531-5037
- Language
- English
- Date published
- 08/2017
- Academic Unit
- Stead Family Department of Pediatrics; Surgery
- Record Identifier
- 9984051766402771
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